Provider Demographics
NPI:1629380266
Name:HUBBARD, LORA RENEE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:RENEE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 MICHAEL DR
Mailing Address - Street 2:BRECKENRIDGE HIGHLANDS
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3942
Mailing Address - Country:US
Mailing Address - Phone:412-389-4843
Mailing Address - Fax:
Practice Address - Street 1:1307 MICHAEL DR
Practice Address - Street 2:BRECKENRIDGE HIGHLANDS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3942
Practice Address - Country:US
Practice Address - Phone:412-389-4843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional